Image Source: Owl Illustration Agency on Unsplash The healthcare sector’s overwhelming complacency with current female hormonal contraceptives has resulted in a lack of innovation for new methods. Between 2017 and 2020 , pharmaceutical companies funded no more than 25 clinical trials worldwide for contraception options, with most studies focusing on incremental changes to existing hormonal contraception options. This is staggering in comparison to 2019 alone, when industry funding supported around 3,100 cancer drug trials and 600 cardiovascular drug trials. For some women who use hormonal contraception, serious side effects can emerge, and alternative options are often limited or unsuitable, restricting full agency over their bodies. Many medical professionals’ perceptions of these side effects can push aside women’s experiences and perpetuate institutionalised misogyny  and medical bias . This gap in research is failing women; impactful changes are needed for female reproductive health to become a priority in medicine. Stories Told by Female Friends I spent the entirety of my education at an all-girls school, where frequent open discussions among my peers about the obstacles we faced as females took place: from one friend throwing up during her Intrauterine Device (IUD) insertion, to stories of catcalling and stalkers. A recent example was my female friend’s visit to a General Practitioner (GP) to start a conversation about changing her contraceptive pill; a story which she is happy for me to share with you. Over the last several months, she had noticed a change in her mood and an increase in her tendency to suffer from anxious and depressed mental states. Within a couple of minutes, sat opposite a male GP, she’d been prescribed antidepressants, along with the dismissal that her contraception wouldn’t be to blame. She left the doctor’s office feeling deflated by her experience of being undermined so swiftly. Dissatisfied with her unwanted new prescription, later that day she phoned to make another appointment to see a female GP. Image Source: Owl Illustration Agency on Unsplash Since recently finishing my Master’s in Psychiatric Research, in my own time, I have been investigating pitfalls in our scientific knowledge, corroborated by stories told to me by the women in my life. In particular, the inadequacy of female contraceptives has been at the forefront of these conversations, understandably so since my friends and I are in our mid-20s. My friend’s account of being patronised in a medical environment is one of many that I have read in books or online, which have infuriated me enough to motivate the writing of this article, in the hope of bringing more awareness to this issue. Although my friend has faced negative side effects, the freedom that hormonal contraception provides for women to have control over their fertility is irrefutable; many women have positive experiences. However, while ‘mood swings’ are known to be a commonly reported side effect of hormonal contraception, information provided on the NHS website  is vague; simply stating that if side effects become a problem, a different contraception may be better suited. In g uidelines from the National Institute for Health and Care Excellence, which advises healthcare providers on the topic of hormonal contraception, there is only a very brief mention of the mental health implications, stating that the manufacturers of hormonal contraceptives are aware of the possible risk for suicide and suicidal behaviour. Across 13 years, a large prospective study  of over 1 million women living in Denmark tracked the association between their hormonal contraception use and risk of depression. The study found that women using hormonal contraception had a slightly higher risk of depression and were more likely to be prescribed antidepressants compared to non-users. But this is one of the very few studies that examines the mental health implications of hormonal contraception.   Fury in Forums and Coercive Consults A quick Google search of depression and hormonal contraception reveals floods of forum posts recounting women’s experiences of side effects, with many describing feeling like an entirely different person. Despite these serious concerns from users over their wellbeing, research into how these side effects can be managed and the development of alternative contraceptive solutions is limited. The lack of research has left a gap in the knowledge of medical professionals, evidenced by my friend’s experience of a GP not taking the time to listen to her concerns about side effects.   Image Source: Owl Illustration Agency on Unsplash Feeling dismissed in healthcare settings is frequently reported by women. Concerns regarding the side effects of contraceptives are no exception. A recent survey  of 188 women found that 43.6% had experienced mood changes as a side effect of their hormonal contraception. The survey also found that side effects were the most common reason that women switched or discontinued their hormonal contraception, with the majority reporting that their healthcare provider had not adequately discussed the possibility of psychological side effects. Furthermore, it was revealed from a study examining women’s lived experiences during consults with medical professionals that many felt a patient-professional power imbalance existed, the relationship even being described by some as coercive when discussing contraception options. Continuing with this kind of research is crucial to identifying the shortcomings and spreading awareness in the medical field in order to bring about change.   A Call for Better Care I expect you’ll be pleased to hear that my friend’s second appointment was much more positive. The female GP showed compassion and empathy for her experience, even to go as far as to apologise upon the retelling of her appointment with the other GP. Taking the time to listen to my friend’s concerns and give her the attention she deserves, the GP thoroughly went through the options available and signposted her to information that would be helpful. The conclusion was to change the contraceptive pill she was taking, and to follow up in a few months to see how her mood was progressing. The GP’s awareness and education of the topic led my friend down a completely different route in comparison to the outcome of the previous appointment.   Image Source: Owl Illustration Agency on Unsplash While my friend had the resilience to advocate for herself, this is not something that should be required of women in order to have their reproductive health concerns addressed sufficiently. The healthcare system’s lack of meaningful advances to improve female contraceptive options is baffling. Urgent funding, research and education are needed in order to expand the medicine available for women to ensure they have autonomy over their reproduction. Until then, women are left with no other choice than to use trial and error with the hope of finding a compatible option, far less than they deserve.

Pregnancy and Postnatal Outcomes of Women with Intellectual Disability. This article is co-written by Ayeshah Mateen Allahwala and Vaheshta Sethna. Ayeshah Mateen Allahwala is a final year psychology student at the University of Karachi, passionate about mental health, human rights, and education. Beyond her studies, she volunteers with NGOs working with children from underserved communities and writes to make mental health knowledge accessible for all. In this blog, she draws on recent research to explore what pregnancy and life after birth are like for women with intellectual disabilities, and how care during and after pregnancy can be better tailored to support them.   Vaheshta Sethna is a Senior Lecturer in Family Perinatal Mental Health (Education) at the Social Genetic Developmental Psychiatry Centre, King’s College London. Her research focuses on the health and needs of families during pregnancy and the postnatal period. She is especially interested in how psychological and social risks, as well as sources of strength, shape a child’s development. Through her work she aims to guide more compassionate and effective support for vulnerable families and foster hope in their care journey. In this piece, she shares insights from her recent work into pregnancy and postnatal outcomes for women with intellectual disabilities and their babies. Photo by Aditya Romansa on Unsplash The moment they meet the world, but it meets them differently   Surrounded by echoes of doctors, nurses, fluorescent lights beaming above, the clatter of medical equipment, a flurry of instructions, sensations, reassurance, overflowing emotions, she lays there as her body and mind are going through unimaginable things, an embodiment of strength, ready to give birth. She feels confused, senses judgement and thinks: “ How will I be able to do this ?”   Motherhood is often seen as a time of significant personal change, filled with both joy and challenges. These challenges can be even more pronounced for mothers with an intellectual disability . What is intellectual disability? Intellectual disability is a neurodevelopmental condition that affects brain development and functioning. It is a lifelong condition that begins before adulthood. Globally, the prevalence of intellectual disability is estimated at 1–3%, with higher rates seen in low- and middle-income countries where access to early intervention and healthcare is limited. According to an internationally recognised framework for diagnosis (i.e. the International Classification of Diseases, 11th Revision ( ICD-11 )), intellectual disability is referred to as a disorder of intellectual development . It is characterised by significantly reduced intellectual functioning and limitations in adaptive behaviours, such as communication, social participation, and independent living. Individuals with an intellectual disability learn and understand things more slowly , and need extra help with daily activities throughout life. When preparing for motherhood, these challenges can turn a healthcare setting into a confusing maze of unfamiliar terms and decisions. For women with an intellectual disability who become mothers, the experience of pregnancy and birth is profoundly shaped not just by their condition, but by how society and the healthcare system respond. And yet, these women carry the same hopes, the same love. Pregnancy & intellectual disability When a woman with an intellectual disability becomes pregnant, she may encounter a distinct set of challenges that impact her physical health, emotional wellbeing, and ability to navigate the healthcare system. Having an intellectual disability often involves difficulties with comprehension, memory, communication, and decision-making; skills that are essential for engaging effectively with healthcare services. Photo by Hans for Unsplash+ The Many Facets of Challenges   Women with an intellectual disability may face multiple barriers in accessing antenatal care (also called prenatal care), the medical support a woman receives during pregnancy to keep both her and her baby healthy. It includes regular check-ups, blood tests, ultrasound scans, advice on nutrition, and guidance on what to expect as the pregnancy progresses. These challenges include communication difficulties, fear of judgment or stigma, and a lack of tailored support. For example, medical advice may be delivered too quickly, in technical language, or without checking for understanding. This can leave women feeling vulnerable, not only medically but emotionally as well. Some women with an intellectual disability have reported inadequate treatment by healthcare staff, including limited understanding of their needs, and insufficient support during pregnancy and childbirth. However, this is not universally observed, suggesting that while negative experiences are reported, they are shaped by differences in staff awareness, training, and healthcare system practices. Therefore, inclusive perinatal care , i.e. care during pregnancy and after giving birth that is flexible, patient-centered, and communication-sensitive, is essential for supporting pregnant women with intellectual disability .   Research Evidence   A recent research study examined pregnancy and postnatal outcomes for women with an intellectual disability to shed light on maternal and infant health outcomes.   The authors used a systematic review study design - a type of scientific study that doesn’t collect new data, instead it is a careful and thorough way of looking at existing published evidence on a specific question to understand what the overall evidence shows.   In this case, the researchers identified previously published global studies, with the aim of finding out:   ● The health risks women with an intellectual disability face during pregnancy ● Potential complications their babies experience.   Through this information, the study aims to provide a clearer, more reliable picture of the challenges- which will help point the way forward for better care.   The researchers screened 103 full-text articles and ultimately included 9 articles (encompassing data from 8 distinct cohorts) that fulfilled the study eligibility criteria (i.e. studies were only eligible if they focused on women with an intellectual disability, defined according to internationally recognised manuals used to identify and describe mental health conditions).   What did the authors report? Women with an intellectual disability are more likely to experience health issues such as urinary tract infections in mid to late pregnancy, gestational hypertension (a condition characterised by high blood pressure that develops after the 20th week of pregnancy in a woman who did not previously have hypertension), and postpartum haemorrhage (heavy bleeding after birth). They are also more likely to experience postpartum haematoma, which is a collection of blood or internal bleeding that happens after childbirth. Women with intellectual disabilities tend to stay longer in hospital after giving birth and are more likely to be discharged to somewhere other than home. Additionally, their babies are more likely to be born premature, at less than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks.  Some babies may require extended neonatal care . Notably, the limited number of studies reviewed showed mixed results regarding the association between intellectual disability and outcomes such as birthweight, congenital conditions (health problems present from birth), Apgar scores (which assess a baby’s health right after birth), stillbirth, and neonatal death. Importantly, the systematic review highlights significant gaps in robust, up-to-date data on this topic. The included studies were limited to high-income countries and the groups of women with intellectual disabilities were much smaller than the comparison groups without disabilities. This smaller sample size may have made it harder to detect rare outcomes, like stillbirth, and as a result, the patterns seen in the data weren’t strong enough to confidently say they weren’t due to chance. Finally, the study only looked at how children developed during their first year of life, indicating that any results related to later development or long-term outcomes weren’t included in the study. Photo by Getty Images for Unsplash+   Why this Review is Significant   This study confirms the urgent need for larger more inclusive studies so we can better support women with intellectual disabilities who often face health inequalities and rely more on services. It provides empirical evidence advocating for change, urging policymakers and pushing for inclusive health strategies such as using simple, easy-to-understand information, providing extra time and support during appointments, and ensuring accessible and patient-centred maternity care – thus, empowering women to make informed decisions throughout pregnancy and childbirth.   Time to Change the Narrative   Ultimately, every mother hopes for a safe birth and a healthy baby. Women with intellectual disability share the same dreams, but the system often meets them differently. By listening more closely, adapting care and treating them with better understanding, healthcare providers can help rewrite this story - one where strength, love, and equity guide every birth.

Disability due to chronic pain is a massive issue in the UK, with millions of people across the country unable to work, see their friends, or perform everyday tasks because of their condition. As an individual with experience in researching chronic pain and educating others about it, I am passionate about understanding the holistic impact pain has on individuals and how this can be managed.  While working at an NHS chronic pain management service, I had many discussions with people living with chronic pain. Service users often expressed how their pain felt invisible to others, and that the public, as well as healthcare professionals, have a very poor understanding of chronic pain. This increases the stigma around pain conditions, causing people with pain to feel isolated, misunderstood, and ignored, negatively impacting their quality of life , both through social isolation, as well as a lack of appropriate support from others. Because of this, I will discuss what chronic pain is and who it most affects, aiming to give you a better understanding of chronic pain in the UK.  Photo by Aarón Blanco Tejedor on UnSplash What Is Chronic Pain?    According to the International Association for the Study of Pain (IASP), pain can be defined as an unpleasant sensory and emotional experience, associated with, or resembling that associated with, actual or potential bodily harm . For pain to be considered chronic, it must persist for at least three months or more . Chronic pain is also categorised into primary and secondary  pain.  Primary  chronic pain often has no clear underlying cause. Pain is the main clinical concern, and examples of this include conditions such as fibromyalgia or chronic low-back pain. Alternatively, secondary  chronic pain initially starts as a symptom of an underlying disease, such as cancer, but can persist once the disease that causes pain has been treated. It is important to note that primary  and secondary  chronic pain can exist simultaneously, and that the causes behind chronic pain can be very complicated, making them very difficult to treat. Types of Chronic Pain   Nociceptive pain is pain that arises from actual damage to non-neurological tissue.  This mainly includes conditions like osteoarthritis, where pain is experienced in joints where the cartilage is worn away, no longer cushioning your bones, causing pain and stiffness. Although some joints, such as your knee, can be replaced to reduce pain, other joints, such as those in your back or hands, cannot be replaced, resulting in long-term pain. The second type of chronic pain is neuropathic pain, where pain arises from nerve damage or dysfunction . This can include direct physical trauma to nerves, the result of infections such as shingles and HIV, or also as a consequence of other health conditions like diabetes and cancer. Pain can exist in the location of nerve damage, but it can also extend to other parts of the body that the nerve communicates with. Neuropathic pain is also often associated with other non-painful symptoms, like pins and needles, numbness, and muscle weakness. Lastly, nociplastic pain manifests when the brain and spinal cord are reorganised to be overly vigilant towards threats , causing them to generate painful sensations in the absence of actual bodily harm, seen in conditions like fibromyalgia. This excessive threat perception has multiple causes, including the sensitivity of nerves that perceive pain from the environment, changes in the nerves in the spinal cord that communicate pain, and alterations in brain areas that evaluate pain. Unlike the other two categories, nociplastic pain can change location, and is often widespread across the body, with the location of the pain unable to be fully explained by neural or non-neural damage. This type of pain is poorly understood by scientists, so  clinicians tend to focus on pain management, as opposed to curing pain , using psychosocial therapies, like cognitive behavioural therapy, to improve quality of life. Photo by Towfiqu Barbhuiya on Pexels Who Lives With Chronic Pain?   Due to chronic pain’s complex and varied aetiology, it is very difficult to treat. A meta-analysis estimates  that in the UK, chronic pain affects around approximately 28 million people nationwide. An estimated 8 million people live with moderately to severely limiting forms of chronic pain, indicating that disability due to pain is a prominent health burden in the UK. Chronic pain tends to more frequently affect older populations, with 62% of the 75-year-old-and-over age group living with pain. When factoring in the UK’s ageing population, the prevalence of pain may further increase, becoming an even greater issue than it currently is, showing the need to conduct research to combat this. As well as older people, women typically report chronic pain more frequently than men. A research study of 19 countries , including the UK, with nearly 30,000 participants found significant gender inequalities in chronic pain, with women experiencing more pain than men consistently across most countries. This study suggests that women may be more susceptible to developing chronic pain than men, and although it is not fully understood why this is, it’s important to recognise this increased risk, particularly by clinical staff when making decisions for patient care.  Socioeconomic factors are also shown to impact the distribution of populations experiencing pain, with those living in deprived areas being more vulnerable to chronic pain. In the UK, there is a higher prevalence of moderately and severely limiting chronic pain in the north compared to the south , mirroring the distribution of other health inequalities, such as obesity, diabetes, and cancer. This can be associated with the north-south divide in the UK, where government policies have led to higher levels of deprivation in the north, resulting in less funding for public services. The lack of access to chronic pain services, such as occupational therapy and return-to-work programmes, for those living in deprived areas of the UK  may further amplify this pain inequality .  Photo by Edward Jenner on Pexels What is the Future of Chronic Pain?   Chronic pain is clearly a very significant issue for the UK, affecting millions of people, and having a significantly detrimental impact on their quality of life . Despite this seeming pessimistic, it’s important to remember that scientists are constantly researching and developing new treatment options for a wide variety of chronic pain conditions, with the aim of eventually curing chronic pain.  As of October 2025, the UK’s Engineering and Physical Sciences Research Council (EPSRC) has started a 6-year funded programme of £11 million focusing on new engineering technologies for chronic pain. These will hopefully include an adaptive brain implant, which responds to pain processing in the brain, as well as special drug delivery systems to help prevent addiction to painkilling drugs. Even though we are still a long way from curing chronic pain, funded research is the way forward in helping people who live with it. Technologies such as neuroimaging, neurotechnology, and pharmaceutical therapeutics will continue to evolve, improving our understanding of chronic pain and, hopefully, enabling us to better support sufferers and reducie the number of people disabled by chronic pain in the future.

On ‘The Traitors UK’, an award-winning reality TV competition , strangers trust and betray one another for the chance to win up to £120,000 (and one more day in the presence of Claudia Winkleman’s fringe). There may be no official strategy for winning, but the players who last longest all seem to understand one thing: psychology. Surrounded by the gothic scenery of the Scottish Highlands, ‘The Traitors’ is a game of social deduction, similar to the party game Mafia , hosted by the effortlessly sharp Claudia Winkleman who secretly selects three players as the titular Traitors. By night, the Traitors gather in secret to choose a faithful to “murder”. By day, suspicion rules, as the group attempts to banish whoever they think is a Traitor. If the Faithfuls eliminate all the Traitors, they share the prize – but if even one Traitor reaches the end by convincing the group they are Faithful, they take everything, making trust a dangerous gamble where perception matters more than truth. With a new season having just aired on New Year’s Day, I’ve found myself watching it with a familiar fascination. As a psychologist - and an avid viewer - I’ve noticed a striking pattern as each new season unfolds: several traits measured by the Hare Psychopathy Checklist–Revised (PCL-R)  seem to repeatedly surface among the most successful players. Those traits are not inherently bad. In fact, in the game of deception, many of the checklist’s “Items” - from charm, lying to manipulation - can offer strategic advantage, especially for those aiming for the finale. In this article, I’ll use the PCL-R as a lens to examine how specific traits play out in The Traitors ,  and why qualities typically viewed as pathological can, in this context, become tools for success. “The Traitors” thumbnail for Season 4, BBC One Items 1 & 9: Superficial Charm & Parasitic Lifestyle To survive early banishments, players must be likeable - not loud. Research shows that trust is shaped less by how candid someone is, and more by how agreeable they seem. Warmth, cooperativeness, and emotional ease signal safety, while dominance and visibility point to threat. As a result, outspoken contestants are often banished early. Armani’s (Traitor) early banishment from Season 3 illustrates it clearly: her confidence and willingness to speak her mind marked her as a risk that Faithfuls sniffed out long before there was evidence against her.   By contrast, players who appear calm and blend into the group appear trustworthy simply by being socially unthreatening. Charlotte’s (Faithful, Series 3) journey shows how her warmth can protect a player even after becoming a Traitor. This same agreeableness  also enables a more passive - what psychologists might call “parasitic” - strategy: contributing just enough to be seen as cooperative, while avoiding leadership and letting others carry the weight of suspicion. That's what led Kasim (Faithful, Season 2) to lose his place in the finale, when he became vocal about his theories. In contrast, the eventual winners consistently minimised their exposure, quietly benefiting from the group’s labour while remaining easy to trust. Item 4: Lying Everyone lies in “The Traitors”, but not everyone does it well - the players who last longer do it without showing the strain of deception. According to studies , when people lie, the stress can cause us to sweat, get lost in narratives, or show Freudian slips. That’s why success lies in consistency and calmness. Participants who can deliver deceit without panic, nervous tics, over-explaining, or becoming defensive stay under the radar longer. Players like Wilf (Traitor, Season 1) and Harry (Traitor, Season 2) survived intense scrutiny not because their stories were flawless, but because their emotional responses matched what honesty is supposed to look like. When lying doesn’t feel stressful, it doesn’t look suspicious. Therefore, remember, the lie matters less than how comfortable you are telling it. Item 5: Conning / Manipulative Manipulation in “The Traitors” is rarely obvious. The successful players  influence others while coming across as passive, validating suspicions, giving suggestions, and letting someone else take ownership of an idea. Traitors who reach the finale tend to avoid confrontation, whilst positioning others as shields or scapegoats. This classic indirect manipulation, where social outcomes are shaped without visible control, has led two Traitors to win. In “The Celebrity Traitors” finale, Joe Marler (Faithful) was the outspoken faithful, ultimately banished, after carrying out the plan that Allan Carr so delicately planted. Yet, nothing can compare to the way two Traitors, Harry and Paul (Season 2), led Miles (Faithful turned Traitor) to trust them, solely to use him as a scapegoat and orchestrate his banishment. This kind of quiet influence allows Traitors to shape outcomes while appearing passive - a powerful combination in a game where visibility equals danger. Items 6 & 8: Lack of Remorse or Guilt & Callousness / Lack of Empathy In “The Traitors”, guilt is a liability. Those who feel bad  about lying often give themselves out by overcompensating - being overly helpful, emotionally incongruent or acting out of character. By contrast, players with reduced remorse maintain behavioural and emotional consistency, which reads as honesty. This trait is crucial to winning. If not for diminished remorse, moments like Harry’s (Traitor) deception of his close friend, Mollie, in the finale of Season 2 - convincing her he was Faithful until the final vote and taking the prize -  would’ve been impossible. Players who can banish confidants and rationalise deceit as “part of the game” avoid showing emotions that might expose them.   However, successful Traitors don’t fully abandon empathy; they use it selectively. Enough to bond, but not enough to hesitate . Whether it’s Wilf turning on his fellow Traitor, Amanda in Series 1, or Alan Carr “murdering” his real-life friend, Paloma, in “Celebrity Traitors”, winning players separate social bonds from strategy, not letting their emotions compromise decision. Harry Clark in the Traitor's Cape Item 7: Shallow Affect A limited emotional range can sound negative, but in the context of “The Traitors” it warrants emotional control. As per studies in organisational settings , people who show strong emotions when questioned are frequently perceived as less truthful than those who stay calm when things get heated. Time after time, season after season, emotionally expressive players who cry, get defensive or angry, are viewed as suspicious, no matter the facts. In Season 1, Faithful Matt was ultimately banished not because of evidence, but because his visible frustration and emotional nature were interpreted as signs of guilt - highlighting how, in “The Traitors”, emotional expression is often mistaken for deception. The Bigger Picture What “The Traitors” ultimately rewards is not morality, but social perception. Studies show that charm, warmth, agreeableness and emotional control are what we base trust on - even when facts point in the other direction. As a result, players who operate those patterns well - staying calm, appearing approachable and not overly dominant - navigate suspicion far better than emotionally reactive contestants or born leaders. And with a new season now airing, you can enjoy watching more closely, noticing how these small psychological patterns quietly influence who makes it to the end. Ultimately, winning “The Traitors” is about being psychologically suited to a game where trust is currency. To paraphrase a classic “you don’t have to be mad to win here… but it helps”.

Dementia is a progressive neurodegenerative condition that affects the brain and causes issues with memory, behaviour, emotions, and communication. The most common form is Alzheimer’s disease, which is characterised by a slow decline in cognitive and motor functioning, with symptoms including trouble concentrating, finding the right words to communicate, issues with remembering events, people and places, and controlling movements. Many individuals also experience secondary mental health symptoms such as depression and low mood, anxiety, aggression, lack of motivation, and hallucinations, all of which have a significant impact on both patients and their families and carers. In the UK, dementia and Alzheimer’s disease account for 1 in 10 deaths , making them the leading cause of death. While the holiday period is often associated with joy, tradition, and togetherness, it can be distressing and emotionally demanding for people living with dementia and those who care for them. Families may come together after time apart, sometimes noticing changes in their loved ones for the first time. My name is Heidi and I am a student on the MSc Clinical Neuropsychiatry course at King’s College London, with a particular interest in neurodegenerative disorders. Through my placement at an adults’ dementia hub, I have become aware of the unique challenges faced by people living with dementia and their carers. For many, this emotional toll can be heightened during the holiday period. Photo by Mario Lopez on Unsplash Challenges for People with Dementia during the Holiday Period Festive occasions can be overwhelming for people living with dementia. Disruptions to familiar routines, unfamiliar social settings, and sensory overload can all contribute to distress. Decorations, flashing lights, loud music, and multiple conversations may trigger confusion and feelings of loss, making celebrations difficult to navigate. According to the Alzheimer’s society, in 2023 around one in four people living with dementia were unable to recognise family members at Christmas, and one in five were unable to hold a conversation with them. When relatives reunite after time apart, changes in cognition and communication may become more noticeable . Difficulties with memory, decision making, and verbal fluency, which are less apparent in brief encounters, can become clearer during longer visits. People with dementia may struggle to recognise relatives they have not seen for some time, which can be particularly distressing when family members expect them to behave as they did previously. This sense of pressure can heighten anxiety and agitation, especially in busy environments, and in situations where young children may not understand these changes. For those living with dementia, the struggle to interact with family members during the holiday period can cause agitation or disorientation, leading to behaviours that appear anti-social, such as withdrawal or shouting. I observed this on one of my placement shifts, when a woman with dementia became distressed after being asked to write her age on a sign-in sheet. Unable to recall information, she grew increasingly agitated and repeatedly tapped her daughter, who was also her carer. The daughter responded calmly and reassuringly, helping her work through the task together. Although this interaction occurred in a seemingly minor situation, it highlighted how everyday demands can become overwhelming. Observing the woman’s distress highlighted the emotional strain individuals with dementia face, and how this can be exacerbated during the holiday period as they try to navigate the world around them with minimal insight into their decline in cognition. The Emotional Impact on dementia carers During the holiday period, carers are often the ones providing support while witnessing changes that may feel more noticeable with each passing year, making this emotional impact especially strong. The end of year period can create a strong sense of responsibility, pressure, and anxiety for carers. They may want to participate in family traditions, whilst simultaneously caring for their loved ones' needs and coping with the memories of how they once were. They may worry about how their loved one will behave in social settings and how their symptoms will manifest as the condition worsens, causing them to be excluded from family gatherings altogether. A 2023 survey by the Alzheimer’s Society found that 65% of current carers reported that Christmas would never be the same, describing how dementia had ‘robbed’ them of a carefree and joyful festive season. This can be particularly difficult when loved ones are no longer able to participate in activities, or when families must celebrate without them, following significant deterioration and a move into residential care. Photo by Bruno Aguirre on Unsplash During group discussions at the hub, facilitated by a qualified counsellor, carers were encouraged to share their experiences and receive professional support. One man caring for his wife reflected on the travelling and activities they once enjoyed together, describing her former personality as bubbly and outgoing. He explained that her behaviour now felt entirely out of character, remarking, “I no longer recognise the woman that I fell in love with.”  This moment captured the grief, emotional strain, and sense of loss many carers experience, even while their loved one is still physically present. Enhancing Wellbeing in Dementia Care One of the most important lessons I learned from volunteering with people living with dementia is the value of simply being present. Many individuals enjoyed talking about their past achievements and memories; having someone listen and ask them questions often made a visible difference to their mood. I regularly attended the ‘Music for the mind’ sessions , where participants could play familiar instruments or listen to music. Some individuals who rarely spoke in other sessions began singing along well-known Christmas songs, highlighting how music can create connections when conversations alone cannot. Its ability to evoke memories, soothe agitation, and enhance meaningful interactions makes music an essential tool for those facing cognitive challenges. Wellbeing walks in nature and hobbies also prove beneficial. For those living alone or in care settings, this offered a sense of safety, routine and companionship. Preferences varied with some enjoying chatting over coffee at the hub, while others preferred quiet activities such as puzzles. One participant told me he felt more optimistic for the rest of his day after the weekly walks. This reinforced the importance of recognising what individuals still enjoy and making a conscious effort to keep those activities part of their lives. Photo by Age Cymru on Unsplash Creating a Dementia-Friendly environment in the New Year In 2025, a record number of people were living with dementia, with around half a million individuals supported by the NHS following a diagnosis. The New Year may be a particularly challenging period after a recent diagnosis, but simple, meaningful activities can make a significant difference for both patients and carers. After spending more time together over the holidays, families may begin to recognise changes and seek support. Maintaining consistent routines around mealtimes, daily routines, and sleep, can create a sense of stability. Keeping gatherings small and familiar, and encouraging calm, one-to-one conversations rooted in personal memories or familiar music, can also reduce anxiety and provide reassurance. If someone appears quieter or more withdrawn than in previous years, helping them feel safe and comfortable is often the most valuable response. It is equally important to check in on carers, ensuring they feel supported and able to enjoy time with family they may not often see. By raising awareness of the challenges faced by people living with dementia and their carers at the start of the year, we can foster greater understanding and support to help everyone feel secure, connected with loved ones, and hopeful for the year ahead.

Growing up Muslim, I didn’t have many holiday traditions, so I learned to create my own. Today, I’m a Seattle-based writer who has learned to create traditions and define home on my own terms. As a kid, I couldn’t sing the words to the season’s greatest hits, didn’t spend the last month of the year shopping for presents, and never set out cookies for Santa. Instead, Christmas was a day when I would pick up extra shifts to cover for co-workers who were out of town to see their families, and I’d usually find myself needing to get something from the grocery store, only to realize that everything was closed. I didn’t mind this very much because I knew that the holidays were a special time for other people who may be reuniting with friends and family, and I was never doing anything nearly as sentimental. But when I saw colourful advertisements filled to the brim with candy canes, ornaments, green and red twinkling lights, and hundreds of posts from friends about the most wonderful time of year, I wondered if I was missing out on something special. I felt grateful that I didn’t have to brave the highs and lows of navigating the airports and weather delays during December, but what about everything else? When my now wife and I started dating, we talked about how I had never celebrated Christmas in earnest. She’s Filipino and I’m Pakistani, so we traded stories about her family’s Christmas traditions and how I celebrated Ramadan, usually by breaking my fast with a date as Prophet Muhammad did, or getting a new outfit to celebrate Eid. She told me about the big family get-togethers that her family would have to celebrate Christmas, and how it was a place where she and her cousins could catch up.  Eventually, we moved in together and started celebrating Christmas together. It was an opportunity to create our own rituals , which are crucial for fostering bonds, trust, and belonging. We started with a pre-decorated tree that my mom used to put out when hosting work Christmas parties, so all we had to do was clear a corner of our apartment and plug it in. It was only 2 feet tall, so we put it on a cardboard box covered in a red bedsheet to make it a little more festive. To make my first “official” Christmas celebration more special, my wife wanted to ensure that I had lots of presents to unwrap and filled my stocking to the brim. All of the gifts were things that I had mentioned needing or wanting in passing, like a Polaroid camera or a new scrapbook, and I felt so lucky that someone was paying attention to what mattered to me. Aleenah's Christmas decor in 2021 But the gifts weren’t what made Christmas important to me. It was the fact that we got to define how to celebrate Christmas on our own terms, even if that was different from the traditions we grew up with. It also means that I don’t have to spend it alone anymore. Our rituals extended to include my wife’s family, which helped us feel more connected even when so many other things around us were changing. These days, Christmas with my wife and her family involves wearing matching pajamas, strategically picking gifts for the white elephant gift exchange, and making excuses for why we can’t be next on the karaoke list. One year, we even made paroles, which are traditional Filipino star-shaped lanterns. Sometimes we decorate a gingerbread house before comparing our design choices and promptly biting off a piece to eat. My wife and I also have a smaller celebration on our own, which we spend by decorating our Christmas tree with ornaments we’ve gifted each other every year and visiting holiday markets so we can support local businesses. We love shopping from small businesses and supporting local makers, and I’ve even writteun gift guides about some of my favorite BIPOC-owned businesses to make it easier for others to shop small during this season. With each intentional decision, we’re ensuring that we spend according to our values and support the creatives in our city and beyond. Image Source: Kayle Kaupanger on Unsplash This year, I’ve started a new tradition that was born out of a recent hobby: collecting Inciardi mini prints . I’ve traveled across the country to visit specialty grocery stores, gift shops, and museums to exchange quarters for $1 Inciardi prints, which I collect in my binder that I’ve lovingly organised by theme. Each year, the artist has a booth at the holiday market in Grand Central Terminal and although I wasn’t able to visit in person this year, I did get a chance to grab prints online, including prints from the Grand Central Terminal collection, winter collection, and dinner party collection. My wife got me some mystery packs as an early Christmas present so we could join in on the fun, and we opened them together at home. I had the best time organising each of the prints in the hopes of framing them, and the holiday designs feel even more special because they remind me of the little life that I’ve built at home. Aleenah's Incardi mini prints When I think about all the rituals that we have in our own home, I feel grateful that I get to experience this time of year on my own terms. It’s a reminder that we can decide how we want to celebrate the holidays, religious or not, and to be open to creating new traditions with the people we love.

Pregnancy is expected to be a “one size fits all” phenomenon. Every stereotype of a pregnant person involves peeing on a stick, sharing the happy news with your partner, throwing up every morning, and having a straightforward delivery where you’re screaming out in pain until the miracle of life is pushed out of your body.   However, this isn’t always the case. Not everyone has a planned pregnancy (or conceives after years of trying), not everyone has a partner, not everyone has a complication-free pregnancy, and not everyone has a complication-free delivery. Many books and resources fail to capture just how much of a physical and emotional rollercoaster pregnancy can truly be.  However, Laura Godfrey Isaacs’ recently published book, Pregnancy and Birth: A Graphic Guide  is something I read wearing my researcher hat, and I enjoyed it for a variety of reasons. Cover page of the book. Source: lauragodfreyisaacs.com Before I get into the book, I thought I’d introduce Laura, whose work has previously been talked about on Inspire the Mind here , and here . Laura  is a midwife, writer, graphic artist, and creative producer, whose career is “ dedicated to exploring the lived experience and politics of the representation of women’s bodies” . This book has been a collaboration between Laura and illustrator Lilly Williams, and guides the reader through one of the (aptly called) ‘most significant adventures’ in their life. Rather than telling the reader that "this will be all positive", she highlights that this experience can be one with excitement, fear, and ambivalence – all of which are normal. At the beginning, she explains that this is a book not only for people who are currently pregnant, but also for those thinking about starting a family, and I think that’s great. More research is emerging focusing on pre-conception mental health as a precursor to perinatal mental health, so having adequate resources to refer to before becoming pregnant can go a long way. I also like the focus on fear of brth and birth trauma, two very significant things that aren’t talked about enough. Birth trauma has been investigated as a prominent risk factor for postnatal depression, and can often manifest as childbirth-related post-traumatic stress disorder. It is essential to talk about these potential complications. What I truly appreciated is how inclusive it is. And when I had a brief look at Amazon reviews of the book, nearly all of them highlighted this as one of the major strengths of the book. Not only do they use inclusive language, but also inclusive illustrations, like the one below. Image credit: Lilly Williams Understandably, a great deal is actually focused on birth. Once again, I appreciated how appropriate the illustrations were. I especially liked that female reproductive organs were not censored out. I know there is a great deal of debate about the censorship of labour online. In fact, there was a time when Instagram had banned photos of childbirth online. This ban was removed in 2018 after considerable controversy . I am of the school of thought that childbirth, a natural process, should never be censored. If age-appropriate movies and TV shows show explicit sexual scenes and nudity, why is childbirth not held to the same standard? This is particularly why I liked the illustrations in this book. Image credit: Lilly Williams As a writer and editor for Inspire the Mind, I am passionate about making science accessible and understandable beyond the world of academia. It is no surprise, therefore, that what I liked about Laura’s book is the use of accessible language when explaining the science and the physiology of labour and delivery. Through Lilly’s appropriate illustrations and Laura’s midwifery experience, readers are able to understand complex concepts through pictures and words. In chronological order, the final sections of the book are all about postpartum care, for both mum and baby. Within this section, I liked the focus on breastfeeding, specifically because it did not shame those who choose not to, or simply cannot, breastfeed. It goes on to explain problems that may arise while feeding a newborn, while sharing practical tips on how to work around them.   Above all, I simply did enjoy reading this book. I didn’t read it from the perspective of a female who one day hopes to start a family, but as a researcher, trained to critique and read with a very fine lens. Yet, as I read, I found myself genuinely enjoying it and appreciating the author and illustrator for the thoughtful work they’ve done in creating an inclusive and relevant book. They avoid falling into the trap of toxic positivity. There’s no suggestion that everything will magically be “all fine and dandy.” Instead, they offer a very realistic, honest, and relatable picture. In an age of information overload, rampant misinformation, and opinions flying from every direction, on social media, in the news, and beyond, it is resources like this that truly make a difference.

Britain faces a growing mental health crisis, yet the narrative increasingly blames individuals rather than the conditions that shape their lives.   Earlier this year, Sir Tony Blair attracted attention on a popular YouTube channel  when questioning the rise in UK mental health spending. He suggested that a rise in self-diagnosis and a trend in pathologising life’s “ups and downs” were to blame. His comments poignantly capture the scepticism surrounding our current mental health crisis and failed to address the question posed to him: why is the UK struggling more than other countries?    I am a resident doctor working in London (South London and Maudsley NHS Trust), nearing the end of my training in General Adult Psychiatry. At work, I’ve seen how social deprivation and service pressures can worsen mental health and limit recovery. The growing trend of blaming those seeking help is alarming. But I am hopeful that as a profession, we have the skills and insight to set the record straight and influence policy towards better investment. Anti-psychiatry attitudes thrive in the sphere of misinformation and 'them-versus-us' rhetoric. The overarching purpose of this strategy must therefore be to rebuild trust in and respect for the profession, by communication which outsmarts and connects.   Social inequalities and mental health With the aim of reducing health inequality in England, the landmark Marmot Review (2010) , identified several critical social determinants of health, and subsequently produced policy objectives for “fair society, healthy lives”. These ranged from early childhood support to fair employment conditions. Despite recommendations, the 10 years on review (2020)  highlighted that life expectancy had stagnated and, even more concerning, that mortality had increased in some age groups. Since austerity measures were introduced in 2010, “deaths of despair” for example through drug-poisoning, alcoholism, and suicide had increased, suggesting the toll of a weakened social infrastructure. Childhood poverty has risen and youth centres and transformative initiatives, like Sure Start, have closed. This contrasts with evidence that early investment yields long-term social and economic benefits . To follow on from Tony Blair’s comments, it seems that life’s “ups and downs” are becoming extreme.  Photo by Liza Summer on Pexels In the midst of it, inspiring initiatives such as the Royal Foundation Centre for Early Childhood  demonstrates a cross-sector desire for improving children’s early life experiences, and a recognition that such protective factors reduce future mental health problems.    So, why the scepticism, since we’ve seen good evidence and communities aspiring for better? High profile, politicised, and non-expert comments, amid a hot-take and sound-bite culture, can well undermine awareness of the mental health crisis.   Stigma lives on, emerging under the guise of “reasonable concern”. Mental health’s complexity renders it vulnerable to misunderstanding and neglect. Politicians frequently condemn a “sick note culture”, deflecting attention from structural drivers of this crisis. But psychiatry has both an ethical and professional responsibility to address stigma, especially when portrayed as justifiable.    How can we do this? Photo by Diego PH on Unsplash A strategy to reduce anti-psychiatry narratives Reclaim the Narrative :  Public-facing campaigns should vividly bring to focus these social determinants of mental health in the context of our current crisis. This could occur with memorable statements and storytelling: “Mental health starts at home.. At school.. At work. ” Connecting early adversity to current presentations at the NHS front-line can highlight the need for a compassionate and urgent public health approach, whilst resisting the drift towards individual blame.   Language guides for politicians and journalists could prevent the misuse and weaponisation of medical phrases; conflating over-medicalisation with over-diagnosis is allowing mental distress to be trivialised. Distress rooted in social deprivation may not require a traditional medical approach, but the underlying suffering remains valid.   Good care of mental illness, regardless of a diagnosis, requires proper formulation and holistic intervention. Long waiting and reduced funding make this less likely, and without timely assessment, the public may turn to self-diagnosis. This is not a crime, but a symptom of cracks in the system. Psychiatry continues to absorb the consequences of societal ills. This does not make the individual less unwell, nor the crisis less real.    Take Stigma Seriously :  For some, the experienced stigma of mental illness is worse than the distress caused by the condition itself, coined “the double blow”. The Lancet Commission on ending stigma and discrimination in mental health  described stigma as a barrier to basic human rights. The ethical weight of anti-stigma interventions should be reflected in evidence-based designs and careful application.   Recent research by King’s Business School indicates that the limited impact of major anti-stigma campaigns may be explained by the diversity of public beliefs and styles of thinking. Those that tend to categorise, are more likely to stigmatise and also respond better to physical health analogies for mental health. Emerging research also shows that supporting lived experience advocates to tell their story, and using human connection, is one of the most consistently effective ways to reduce stigma.   Audio-visual campaigns can be co-created with charities and foundations, in the hope that with a strong network and a shared voice comes sustainability and consistency that sticks. Political pleas by celebrities can be far-reaching. For example, Ed Sheeran’s recent letter  to the government has prompted reform of music education in schools. Perhaps mental health champions can do the same.    Accountability is a key aspect of this pillar. Trivialising mental distress or framing help-seeking as malingering is becoming commonplace in UK politics and can powerfully undermine any anti-stigma campaign. A task force could monitor media, identify recurring themes and flag high-impact stigmatising rhetoric that requires timely and proportionate response. Once rhetoric is named clearly as stigma, the narrative may become less socially acceptable. Involving psychiatry trainees in anti-stigma interventions could also encourage a generation of doctors confident in advocating and clear in their approach.     Mental Health Dividends : Finally, and perhaps most importantly, there must be a clear demonstration that investing now will pay dividends in the future. Money speaks, particularly during times of fiscal constraint.   The Royal College has already made its “ Economic Case for Good Mental Health ”. The investment is financially sensible, but can we go further to be heard? Whilst being careful to avoid being partisan, strategy could include scrutiny of where public money actually goes , investigating the cost of out-sourced for-profit private services with poorer outcomes. If this is presented as an economical comparison, is the choice to invest back in our services a more comfortable one?   Rising scepticism toward the UK’s mental health crisis ignores both evidence and undermines public goodwill. Psychiatrists are positioned to lead on an evidence-based response. But this will have greater impact if co-ordinated with other initiatives, charities and foundations that already exist within the network. To cut-through misinformation and a simplistic, divisive rhetoric, communication needs to be smart and provoke empathy.     This piece has received the South London and Maudsley NHA Trust Training Programme - Lade Smith Essay Prize"

Trigger Warning:   The following article mentions suicide, which readers may find distressing. I will shift. Two teenagers scribbled this same line repeatedly in their journals. Both later died by suicide after extensive interactions with Character.AI chatbots. Photo by Krismas on Unsplash These are just two of several high-profile US cases linking AI-generated “character” companions, designed for open-ended role-play and conversation, with teen mental-health crises, a pattern that drew a Congressional hearing in September. I’m a postgraduate student on the Mind-Body Interface MSc at KCL, and I’m fascinated by how these kinds of emergent technologies are shaping future generations. What struck me about these two cases was the shared desire to “shift” into a different reality. Reality-shifting is a fringe online belief that one can leave their current world and “shift” their consciousness into a desired reality – often a fictional universe – by using visualisation, affirmations and ritualised techniques. Indeed, one of the teens promised to “come home” to his chatbot seconds before his death, suggesting he may have believed in an alternative reality in which they could be together. Reality-shifting is an avoidance strategy, not a solution. While these cases are extreme, they highlight a central tension of adolescence – escaping reality versus learning to adaptively cope within it – and the potentially devastating results when teens choose a maladaptive coping strategy. This piece explores the idea that companion chatbots can either impede teenagers’ abilities to cope with stress or help them cope – depending on design. I look first at what healthy and unhealthy coping look like, then why adolescence is a sensitive window, and finally the opportunity for chatbots to steer teens back to real-world engagement. Constructive control & coping A sense of control is fundamental to wellbeing, especially in the face of the unavoidable stresses of life. Professor of Adolescent and Child Psychiatry Andrea Danese explains: “Facing challenges and distress is […] [how young people] learn coping skills in the face of many small challenges and build self-confidence about their ability to cope.” Photo by Zan Lazarevic on Unsplash But of course, we are not born knowing how to cope; we develop these skills over time. Healthy coping involves restoring a sense of control and follows the principle: “change the world when you can, change yourself when you can’t.” When we tackle a situation directly, we might problem-solve, plan, seek help, or set boundaries. This is changing the world – what psychologists call primary control. When the situation is not in our control, coping means adjusting our response by reframing the problem, changing our expectations, accepting what cannot be changed, or finding meaning in the problem or outcome. This is changing ourselves – or secondary control. Critically, no single strategy works in every situation. Healthy coping requires flexible coping: recognising what type of challenge we are facing and shifting strategy as circumstances change. This is a healthy, adaptive form of “shifting.” Research consistently shows that control-based coping – engaging with a stressor – is associated with fewer mental-health and behavioural issues in adolescents. In contrast, avoidance (withdrawal, denial, suppression, wishful thinking) is associated with more. This is where AI chatbots can pose a risk, by creating an illusion of control while making disengagement easier: in one other reported case involving Character.AI, a teen wrote that the bots “gave me an escape into another world where I can choose what happens.” Such a fantasy of control can be especially appealing for teens who are already struggling. Photo by Getty Images on Unsplash Why adolescence matters Adolescence is a formative developmental window. Young people separate from caregivers, make independent decisions, and face consequences that build competence and identity. AI companions, by design, can provide a world without real stakes – one that may draw time and emotional energy away from real-world practice and growth. Research suggests that heavier use of AI companions in adolescence is associated with poorer mental-health outcomes. More time spent chatting with AI correlates with greater loneliness, reduced face-to-face social interaction, increased emotional dependence on the chatbot, and more problematic or compulsive use. These patterns may be particularly concerning for younger teens, whose impulse control and ability to tolerate difficult emotions are still developing. Photo by Norma Mortenson on Pexels At the same time, new coping skills come online in adolescence. Teens become better at employing cognitive strategies like self-regulation of emotions. With the development of executive skills and greater self-awareness, teens are better able to use those healthy coping mechanisms with flexibility. Because the adolescent brain is highly plastic, skills learned are also more likely to stick, making it a prime window of opportunity for wiring the control-based coping skills that support mental health. AI chatbots can get in the way of this high-impact learning, or strengthen it – depending on design.   Working towards optimal chatbot design: a bridge back to reality In the wake of tragic cases like those discussed in this piece, major AI companies have made changes. While some safeguards – enhanced age verification and stricter limits around self-harm and sexual content – arguably should have been in place from the start, I feel optimistic. OpenAI has clarified that its goal is to help people “make progress, learn something new, or solve a problem – and then get back to your life.” When the goal becomes empowering next steps forward in the user’s real life, not holding their attention, design shifts in the right direction. Updated OpenAI models, built with input from more than 170 mental health experts, now use well-established strategies for handling sensitive conversations: grounding exercises, de-escalation, and pointing to real-world resources. The initial reported quality improvements in distress situations are promising. Beyond serving as a first line of defence that keeps teens safe in the moment, the same technology can potentially coach the everyday coping skills that fortify mental health. But this is where structure matters. Purely open-ended conversation can invite over-reliance and waffling that easily drifts to heavy usage. In a significant shift, on 29 October, Character.AI announced it would remove all open-ended chats for under-18s, with strict usage caps. By contrast, when chatbots guide self-reflection or a task in a structured, goal-oriented way – for example by role-playing a single situation – interactions stay brief and lead to less dependence and problematic use. Early research is promising: adolescents report being open to chatbot-based life-skills coaching . Photo by Tima Miroshnichenko Pexels Having structure in place for chatbot interactions likely helps organise emotional processing and build capability. My hope is that companion chatbots are designed around these principles. If they are, they could help teens judge situational controllability, apply adaptive strategies that restore their sense of control, and put those skills into action in their offline lives. If chatbots support coping in the real world, rather than serve as an escape from it, they could help teens shift skills, not reality – and build resilience over time.

How nostalgia makes us yearn for our own memories. Time moves forward whether we follow it or not. Nostalgia, however, waits. It lingers in old songs, in familiar streets, in the scent of a season or a person we thought we had forgotten. And when it finally returns, it pulls us gently, and sometimes painfully, back into a moment we can no longer touch. Nostalgia is one of the few emotions that can ache and soothe at the same time. It can be described as a bittersweet affect, a blend of longing and warmth, loss and belonging. And yet, most of us know it long before we can even define it. Source: Bruno Martins via Unsplash As a psychology and neuroscience graduate, I am deeply interested in how memory and emotion are embedded in the brain and how they intertwine with the body. After completing my MSc in Psychology and Neuroscience of Mind-Body Interface at King’s College London and returning home to Vienna, I found myself overwhelmed by nostalgia to the point where I could feel it tightening my chest. I wanted to understand why certain moments linger so vividly and why they ache in such a tender, almost physical way.   Andy Bernard from The Office said it better than most philosophers: “I wish there was a way to know you’re in the good old days before you’ve actually left them.” Sometimes we do know. There are rare, glowing moments in life when we sense, even while they are still happening, that we will one day look back on them with tenderness. A burst of laughter among friends. A late-night walk in a new city. An evening with someone special. A perfect meal you once had. An activity you have wanted to try out forever. A day that seemed ordinary until it wasn’t. But more often, nostalgia reveals its value only afterwards. And then it comes quietly, unexpectedly, in the smallest triggers: a song, a street corner, a smell. Source: Timothy Raggett via Unsplash Although nostalgia feels warm and familiar today, it was once seen as an illness - first described by physician Johannes Hofer as a form of homesickness that could cause emotional and even physical symptoms . Modern research views it very differently: what feels emotional and intuitive is deeply grounded in psychology and neuroscience. Nostalgia is understood as a fundamentally social emotion that strengthens belonging and connectedness, especially during transitions . Neuroimaging studies show that nostalgic recall activates brain regions involved in autobiographical memory, self-reflection, emotion regulation, and reward. However, nostalgia is not uniformly uplifting. It can increase positive affect, yet its spontaneous occurrence is linked to more mixed well-being outcomes , reflecting its bittersweet nature. Still, this bittersweetness appears adaptive: nostalgia may buffer self-esteem when loneliness is present and help keep our sense of self steady during life changes . Taken together, nostalgia is not merely an emotional echo of the past but a mind-body regulatory process that intertwines memory, social connection, and physiological calm. After spending a year in London - my dream city and a place I had imagined for years - coming back home to Vienna has made nostalgia feel stronger than time itself. It sneaks in through old routines: a song I used to listen to on my way to class, a picture of a street I walked down every day, the particular kind of London rain that somehow smells like concrete, cold air, and new chapters. Looking back, the whole year feels strangely cinematic, though not always in the graceful, glossy way of a Hugh Grant romantic comedy - more like living inside Bridget Jones’s Diary : slightly chaotic, a bit ridiculous, unexpectedly heartfelt, and full of moments that now feel larger than life. Source: Bruno Martins via Unsplash The tiny, unimportant moments become part of the whole movie. And the funny thing is: I didn’t expect to miss the things I miss so deeply now. The stressful library days during exam season. The packed tube at rush hour, where everyone collectively gave up on breathing. Nearly getting swallowed by tourist crowds in Covent Garden. All the things I once rolled my eyes at, I now look back on with an affection that feels almost irrational. But that is what nostalgia does. It edits your personal history, gently but decisively, colouring everything with a glow you only recognise afterwards. Studying for exams becomes less about stress and more about sitting next to friends who were struggling just as much. Rush hour becomes the prelude to meeting someone you really liked. Even the tourist chaos becomes a reminder that you lived in a place that people dream about. It turns out the small, in-between moments become the ones you ache for later. How often do we wish for just one more normal night at the pub, the kind we had a hundred times without realising they were becoming memories as they happened? Source: Vann via Unsplash Our generation - the much-discussed, occasionally over-analysed Gen Z - seems to feel nostalgia on an unusually deep level. We have an almost instinctive urge to hold on to every moment, to document everything, to romanticise even the most mundane parts of our lives. Not because we’re dramatic (well… maybe a little), but because time feels like it is moving faster than it used to. Where our parents might have taken one or two blurry photos at a concert, we now see an entire sea of glowing screens held up toward the stage. People aren’t just filming, they’re archiving - we’re building small digital museums of our own lives. After all, this is an attempt to slow down time. Nowadays, academic, financial, and social pressures make everything feel compressed - careers that start earlier, expectations that pile higher, and a world that keeps spinning even when we’re not ready to keep up. Capturing a moment becomes a way of stretching it, saving it.  Source: Konstantin Kitsenuik via Unsplash Even ABBA sang, “Sometimes I wish that I could freeze the picture and save it from the funny tricks of time.” And perhaps that is what nostalgia really is: an instinctive attempt to hold still what refuses to stay. Maybe nostalgia is less about longing for the past and more about recognising the parts of ourselves we left there - our younger versions who tried and learned and the places and people that held us. Arriving long after the moment has passed, nostalgia pulls us back with a tenderness that feels almost physical, reminding us we once lived fully in a time we didn’t yet know we’d miss.   And sometimes it hurts. But perhaps the ache is just evidence that something truly mattered.

Image by Getty Image on Unsplash+ The first time I heard about circadian rhythms was in my high school biology class. I remember breezing past the term, memorising that “circadian rhythms = sleep-wake cycles,” and not thinking much more about it. That is, until I started to study them in graduate school. As scientists have uncovered more about circadian rhythms, we now realise how deeply they affect our health and daily lives. Circadian rhythms are the body’s hidden timekeepers, quietly influencing when we feel alert, hungry, or even happy. In fact, the study of time, known as chronobiology , has blossomed into interdisciplinary fields such as chronopharmacology/chronotherapy, which examines how the timing of drug administration and therapeutics can change their efficacy and side effects, and chronopsychology, which explores how timing influences psychological processes like memory, perception, mood, and performance. Building on this emerging science, my research explores how circadian timing shapes the brain. I am a PhD student in Dr Laura Fonken’s laboratory at The University of Texas at Austin, where I study how the body’s internal clock interacts with the brain’s immune system to influence mood and behaviour. This article explores the different factors that influence circadian rhythms and some strategies to improve circadian health. Image by Elenabsl on Adobe Stock What is The Circadian System? The word circadian,  coined by Dr Franz Halberg in 1959, derives from the Latin words circa  (“ around ”) and dies (“ day ”), meaning “approximately a day.” Circadian rhythms are the body’s approximately 24-hour clock that helps maintain alignment with the Earth’s day and night. Over time, this internal timing evolved to help living organisms anticipate and adapt to the predictable daily changes in their environment. Essentially, circadian rhythms optimise bodily processes by using and conserving energy at the appropriate times. Observations of daily biological rhythms date back as far as the 4 th  century BCE, when the Greek philosopher Theophrastus noted that tamarind tree leaves opened at sunrise and closed at night. Nearly 2,000 years later, advances in DNA sequencing revealed that a network of genes controls these daily patterns. Researchers named the gene network the “molecular clock” and discovered that it runs automatically within almost all living organisms – from bacteria to plants to animals, including humans. Remarkably, the molecular clock keeps running without external cues, like light. For example, in studies where participants spend weeks in caves  without access to natural light, they continue to wake up at consistent times each day, guided by their internal clock rather than sunlight. In another study , volunteers lived in bunkers unaware of day or night, yet their body temperature, activity levels, and even urine production maintained a roughly 24-hour rhythm (the scientists explain this in more detail here !). These studies proved that our sense of time is not merely set by the environment; it is hard-wired into our biology. However, just like a mechanical clock, the circadian system can drift because the internal rhythm is not perfectly  24 hours long. To stay on track, it needs regular “resets” or resynchronisations through environmental cues like light, food, and social activity. Light: The Most Influential Timekeeper While circadian rhythms repeat on their own, there are synchronisers in our environment that act as time cues known as “zeitgebers”. The light/dark cycle is the most important zeitgeber. When light enters the eyes, it sends information to a small brain region called the suprachiasmatic nucleus (SCN), which acts as the body’s “primary clock.” The SCN then helps coordinate clocks throughout the brain and body. Viewing morning sunlight helps “jumpstart” the circadian system. Does this mean staring directly at the sun is good for you? No. However, getting natural light early in the day (even just 10 minutes, though 30 is even better! ) is extremely beneficial. Even on cloudy days, outdoor light can still be far brighter than indoor light, signaling your brain to wake up and be alert. When light is perceived after sunset, it disrupts this synchronisation. The SCN interprets nighttime light as daytime, disrupting the molecular clock and suppressing melatonin, a hormone that promotes sleep. Light signals can also reach other brain regions involved in mood and anxiety regulation. Over time, repeated misalignment can desynchronise internal systems , leading to impaired alertness, mood disturbances, metabolic dysregulation, and increased risk for chronic conditions such as obesity, diabetes, and depression. In this way, light acts both as a timekeeper and a potential disruptor: when timed correctly, it reinforces healthy circadian rhythms; when mistimed, it confuses the body’s sense of day and throws bodily processes out of sync. Image by Oleg on Adobe Stock Feeding the Clock: Food as Another Timing Cue Food is another timing cue for the body. Regular meal timing ensures that digestion, metabolism, and energy use occur at biologically appropriate times. It also ensures that the body can rest and repair during the fasting phase. When food intake is irregular or occurs late at night, it can send conflicting signals to the body. Eating at all hours of the day has also been linked to a host of problems , including increased risk of obesity, insulin resistance, heart disease, and chronic inflammation. Approaches like intermittent fasting (or time-restricted feeding in animal research) leverage circadian rhythms by limiting food intake to a consistent window each day, often within 8-12 hours during wakefulness.  Interestingly, recent research has shown that when we eat is almost as important as what we eat. One study showed that mice fed a high-fat diet under time-restricted feeding were protected  from obesity, excess amounts of insulin in their blood, and inflammation even though they consumed the same number of calories as mice that ate freely throughout the day. Furthermore, time-restricted feeding may also improve mood: my research from the Fonken Lab  showed that time-restricted feeding improved sociability and reduced behaviours associated with anxiety in mice. While these studies were conducted in animals, growing evidence suggests that humans benefit from intermittent fasting as well. So what does this mean? For humans, consistent, daytime-aligned feeding schedules can help reinforce circadian rhythms and promote health, whereas irregular or nighttime eating patterns can desynchronise the body clock and impair normal bodily functions. Connection and the Clock: Social Life Shapes Timekeeping Too Nearly every person has an internal timing preference. Some are “early birds”, while others are “night owls.” This natural variation influences when we feel most alert or tired, and problems arrive when social schedules (like school or work start times) don’t match our internal clocks. This mismatch, called social jetlag, can leave us feeling perpetually tired and out of sync. But, social jetlag is not just about feeling groggy. It reflects a chronic misalignment  between biological and social time that can affect mood and long-term health. Like irregular light exposure and eating habits discussed above, social jetlag is linked to high risks of obesity, diabetes, depression, and heart disease. It tends to peak in young adulthood, when biological clocks naturally run late, and often declines with age as people gain more control over their schedules. It is also common among “night owls,” whose natural rhythms clash with early work schedules. The good news: when social and biological time align, people usually experience better sleep, higher energy, and improved mood and performance. Regular exercise, shared meals, and consistent social routines act as beneficial time signals that reinforce the body’s natural rhythms, supporting metabolic and mental health. Keeping Rhythms in Sync: Strategies for Circadian Health We’ve briefly touched on three factors that can influence our circadian rhythms, though many others such as physical activity, stress, and genetics also play significant roles. Modern life has decoupled human routines from natural day-night light cycles, but small, intentional changes can help realign our internal clocks. Prioritising morning light exposure, maintaining regular sleep and meal times, limiting bright light (especially screens) before bed, and building consistent daily routines all support circadian health. When our internal rhythms are in sync with the environment, we tend to sleep better, think more clearly, and feel more energised throughout the day!

I am a mental health researcher working on the HappyMums project , a European consortium that focuses on understanding depression in pregnancy. At King’s College London, we are leading a clinical study involving the use of a smartphone application called the HappyMums App .  Research is often a collaborative approach across different countries, and we, in this project are collaborating with institutions across Europe. Since the start of our project, much of our discussions have been about privacy and data sharing. The idea of having a large-scale dataset encompassing a thousand participants , across seven different sites, and finding a way to analyse this data, always seemed like a gargantuan task. Today, I'm writing this piece for Inspire the Mind, to highlight how clincial research data can be analysed to advance screening and monitoring of mental health symptoms across the world in a way which does not violate data sharing rules. Our collaborators from the Artificial Intelligence in Medicine Lab at the University of Barcelona proposed the idea of developing a federated learning (FL) platform as a solution, which I had never heard of before. Photo by Kaleidico on Unsplash So, what exactly is it, and how does it differ from a centralised approach? Traditionally, centralised approaches to data analysis have been used in mental health research. Data is stored at one site, and each site runs its own analyses, or has to go through hours or days of paperwork to even start thinking about sharing data. The solution? Federated analysis. The federated analysis method is a way to train Ai models without data ever leaving the device it is collected on. It gives collaborators the opportunity to “ remotely share their data to collaboratively train a single deep learning model” . Speaking in practical terms, an environment downloaded on a device from each data collecting site will enable an Ai model to be developed without this data ever leaving their server. Let me explain this in Stranger Things terms (I’m loving season 4 and can't stop thinking about this). In federated analysis terms, it would be like all the children looking for ways to defeat Vecna in their own time, in their own homes. Instead of bringing actual clues and materials to their key hideout spot, they do the detective work in their own spaces and bring their conclusions to their hideout and brainstorm ways to defeat Vecna. So, above all, this method allows researchers to utilise large amounts of data while respecting participant privacy and legal obligations . The federated analysis approach was first introduced in 2016, with published research in mental health appearing in 2019 . This does show that this approach to mental health research is still in its very early stages, with the number of publications using this approach rising from 7 in 2021 to more than 10 in 2023. The approach has been explored mostly in relation to depression, but other work has looked at its implementation with Bipolar Disorder and Obsessive Compulsive Disorder . To advance the usage of this approach in mental health, researchers have suggested finding practical implementation solutions, such as an understanding of the technical software and hardware, computational resources, and organisational limitations. Additionally, due to participant heterogeneity, it is recommended to ensure that models adapt to individual characteristics , to ensure that patients can benefit from Ai models equally.   Photo by Growtika on Unsplash   The novelty brought by the HappyMums project: In the field of perinatal mental health, published research is even more limited. A 2023 study has used population birth data in Europe and developed a Common Data Model to understand perinatal indicators from routine medical information. To the best of my knowledge, based on the current state of the literature, no research project has used this approach for a clinical study; i.e., newly generated real-world participant data, not available in existing healthcare databases. What is unique about our project is that clinical and digital data from numerous sites across Europe will be analysed through the FL platform. Photo by Anna Tarazevich on Pexels Applications within the broader sphere of women’s health Within the wider space of women’s health, this approach can have transformative potential. The field of FemTech (tech-driven products like apps and wearable devices to address female health, like pregnancy and menopause) has seen a boom in recent years, and federated analysis could have numerous benefits in this regard. In fact, in early 2025, an ovulation tracking app called FLORA used the FL approach to provide personalised health insights, while also addressing the privacy concerns of users as a case study in this field. Ai models have also been applied in the context of menstrual care and breast cancer screening. Federated analysis takes this progress further by integrating diverse datasets from across the globe. This allows for the creation of more representative and inclusive models that truly serve all women, everywhere. Benefits and drawbacks: Coming back to my personal experience with FL platforms, I must say that I am in no way an expert in Ai or computer science, with no prior experience with coding. I was initially sceptical about this approach as it had never been used in our lab. With the immense help from our collaborators in Barcelona, I was able to download the environment on my laptop, and we jokingly said that by the end of this, I would have a joint PhD in maternal mental health as well as computer science. I am excited to implement this approach for the HappyMums clinical study, because it will allow for improved data diversity and representation from our Europe-wide sample. This model will allow us to collaborate and share data without relying on legal delays and data transfer agreements. With news that sensitive patient data is breached in cyberattacks, I do hope that federated analysis will be a solution to data privacy, seeing as the data never leaves secure computer servers. One of the drawbacks of this approach is that it involves a large amount of technical setup, which can be difficult for those outside of the field of technology and computer science. For this, researchers need to make sure their organisations have the correct infrastructure and permissions, which, if not in place, can add a great deal of complexity. Additionally, if a data collection plan has not been decided beforehand, it can be quite challenging to harmonise the data, and inconsistencies in data collection can lead to delays in this process.   With that being said, from my emerging involvement with this approach, I do believe that the benefits outweigh the drawbacks. If used correctly, FL can lead to great advancements in women’s health and overall mental health research. I no longer have a feeling of dread when I hear Ai, and machine learning, but rather, a sense of excitement.   I will leave you with a quote from Ursula von der Leyen, President of the European Commission from Davos 2024. "I am a tech optimist and, as a medical doctor by training, I know that AI is already revolutionizing healthcare. That's good. AI can boost productivity at unprecedented speed. First movers will be rewarded, and the global race is already on without any question.”   So…Where to, next? Photo by Getty Images for Unsplash+